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Am J Geriatr Psychiatry. 2009 Dec;17(12):1059-67. doi: 10.1097/JGP.0b013e3181b7ef6e.

Risk of death related to psychotropic drug use in older people during the European 2003 heatwave: a population-based case-control study.

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  • 1INSERM U657, UniversitĂ© Victor Segalen Bordeaux 2, Bordeaux cedex, France.

Abstract

OBJECTIVE:

The authors investigated the association between death of older people and use of psychotropic drugs before and during the Western European August 2003 heatwave.

METHOD:

A retrospective population-based case-control study was conducted using the French social security insurance national database. Exposure to psychotropic drugs in cases aged 70-100 years who died before (N = 2,093) and during (N = 9,531) the August 2003 heatwave was compared with those of survivors matched for age, gender, and presence of chronic illness, by using conditional logistic regressions.

RESULTS:

The association between death and psychotropic drug use was modified by level of external temperature (Wald chi(2) = 13.1, degree of freedom = 1, p <0.001). Use of any psychotropic drug was associated with a 30% increased risk of death during the heatwave, with a significant dose-response relationship between the number of psychotropic drugs and the risk of death (adjusted odds ratio [aOR] for linear trend 1.25, 95% confidence interval [95% CI]: 1.21-1.29). During the heatwave, therapeutic classes independently associated with an increased risk of death were antidepressants (aOR 1.71, 95% CI: 1.57-1.86) and antipsychotics (aOR 2.09, 95% CI: 1.89-2.35), whereas exposure to anxiolytics/hypnotics use (aOR 0.85, 0.79-0.91) was associated with a decreased risk. Findings remained unchanged after adjustment on cardiotropic, antidementia, or anti-parkinsonian drug use.

CONCLUSION:

Our findings suggest that a causal relationship may exist between psychotropic drug use during a heatwave and increased risk of death in older people. The risk/benefit ratio of antidepressant and antipsychotic drugs should be carefully assessed in older people during a heatwave.

PMID:
20104062
[PubMed - indexed for MEDLINE]
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